Objective: Huntington’s disease (HD) is characterized by motor, cognitive, and neuropsychiatric symptoms. Oculomotor impairments and gait variability have been independently considered as potential markers in HD. However, an integrated analysis of eye movement and gait is lacking. We performed multiple examinations of eye movement and gait variability in HTT mutation carriers, analyzed the consistency between these parameters and clinical severity, and then examined the associations between oculomotor impairments and gait deficits. Methods: We included 7 patients with pre-HD, 30 patients with HD and 30 age-matched controls. We collected demographic data and assessed the Unified Huntington’s Disease Rating Scale (UHDRS) score. Examinations, including saccades, smooth pursuit tests, and optokinetic (OPK) tests, were performed to evaluate eye movement function. The parameters of gait include stride length, walking velocity, step deviation, step length, and gait phase. Results: HD patients have significant impairments in the latency and velocity of saccades, the gain of smooth pursuit, and the gain and slow phase velocities of OPK tests. Only the speed of saccades significantly differed between pre-HD patients and controls. There are significant impairments in stride length, walking velocity, step length, and gait phase in HD patients. The parameters of eye movement and gait variability in HD patients were consistent with the UHDRS scores. There were significant correlations between eye movement and gait parameters. Conclusion Our results show that eye movement and gait are impaired in HD patients and that the speed of saccades is impaired early in pre-HD. Eye movement and gait abnormalities in HD patients are significantly correlated with clinical disease severity.

Professor Wu Mianhua,a renowned national traditional Chinese medicine(TCM)practitioner,proposed the"deficient qi and Kenang"theory based on the doctrines of"deficient qi"and"Kenang".This theory is applied to the pathogenesis analysis and clinical syndrome differentiation and treatment of brain tumors.It posits that the fundamental pathogenesis of brain tumors involves orig-inal qi deficiency,internal generation of deficient qi,intermingling of phlegm and blood stasis,and conglomeration of toxins into nest-like foci.The treatment strategy emphasizes reinforcing healthy qi,regulating qi,resolving phlegm,dispelling stasis,attacking toxins,dispersing nodules,and adjusting treatment according to disease stages.In the early stage,it is to support healthy qi and regulate qi to remove qi deficiency;in the middle stage,it is to dissipate phlegm and expel blood stasis to resolve pathological nests;in the late stage,it is to attack toxins and resolve masses to break up nest sac.Throughout the treatment,strictly adhere to the principle of"rein-forcing healthy qi without retaining pathogens,and breaking accumulations without impairing healthy qi".

Objective To retrospectively analyze the association between metabolic factors and high-risk colorectal adenoma(CRA).Methods The medical records of patients aged 18-75 years who underwent their initial colonoscopy at Karamay Central Hospital of Xinjiang Uygur Autonomous Region from Jul 2000 to Mar 2017 were collected.The comparison between normal colonoscopy(NC)and high-risk CRA patients was conducted using an unpaired t-test,while chi-square test was used for categorical variables.Least absolute shrinkage and selection operator(LASSO)regression and Logistic regression were utilized to analyze the association between metabolic factors and high-risk CRA.Results A total of 1 798 patients meeting the inclusion and exclusion criteria were enrolled and divided into normal colonoscopy(NC)findings group(n=972)and high-risk CRA group(n=826).The high-risk CRA group exhibited significantly lower levels of high-density lipoprotein cholesterol(HDL-C)in comparison to the NC group,while uric acid and fibrosis 4(FIB-4)index levels were significantly higher than those observed in the NC group(all P<0.05).Based on LASSO regression analysis,we identified 12 variables that potentially influence the occurrence of high-risk CRA,including age,gender,smoking history,alcohol consumption history,non-alcoholic fatty liver disease(NAFLD),hypertension,coronary artery disease,hyperglycemia,hypercholesterolemia,low levels of HDL-C,elevated alanine aminotransferase,and elevated gamma-glutamyl transferase.Multivariate analysis revealed that individuals aged over 50 years,male gender,cigarette and alcohol consumption,low HDL-C levels,history of NAFLD and hypertension were identified as independent risk factors associated with high-risk CRA(P<0.05).In addition,without or with adjusting for age,sex,smoking,and drinking history,patients with a high TG/HDL-C ratio(the ratio≥2.68)had a significantly higher risk of high-risk CRA than those with a low TG/HDL-C ratio(the ratio<2.68)[odds ratios(ORs)were1.430 and 1.235 respectively,all P<0.05)].Without or with adjusting variables,the ORs for NAFLD patients with FIB-4 index>2.67 were 1.849(P=0.466)and 1.435(P=0.707),respectively.Conclusion A significant association exists between metabolic factors and high-risk CRA.Independent risk factors for high-risk CRA include older age(≥50 years),male,smoking history,alcohol consumption history,low levels of HDL-C,and a history of NAFLD and hypertension.Individuals exhibiting a TG/HDL-C ratio exceeding 2.68 manifest a significantly heightened susceptibility to the development of high-risk CRA.Therefore,elderly males with one or more aforementioned metabolic abnormalities should be considered a priority population for colorectal screening.

Objective:To investigate the early diagnostic value of contrast-enhanced ultrasound(CEUS)combined with serum creatinine(Scr)and urea nitrogen(BUN)in children with renal parenchymal injury caused by urinary tract infections(UTIs).Methods:A total of 120 children with UTIs admitted from January 2020 to January 2025 were selected and divided into a renal parenchymal injury group(n=65)and a non-injury group(n=55)based on the results of 99mTc-DMSA renal static imaging.All children underwent CEUS examination within 24 hours of admission to obtain hemodynamic parameters of the renal cortex and medulla(time-to-peak[TTP],peak intensity[PI],and area under the curve[AUC]),and Scr and BUN levels were measured.Multivariate logistic regression analysis was used to identify independent risk factors,and the diagnostic efficacy was evaluated using receiver operating characteristic(ROC)curves.Results:In the renal parenchymal injury group,Scr(0.82±0.25 vs 0.53±0.15 mg/dL),BUN(16.23±4.82 vs 12.42±3.27 mg/dL),and cortical TTP(51.47±12.38 vs 43.45±12.55 s)were significantly elevated,while cortical PI(32.63±6.37 vs 39.23±7.31 dB)and AUC(2915.36±536.37 vs 3415.35±681.5 dB·s)were significantly decreased(all P＜0.05).Multivariate analysis showed that Scr(OR=6.17),BUN(OR=2.58),cortical TTP(OR=1.98),and PI(OR=0.60)were independent predictors.In the ROC curve analysis,the combination of CEUS parameters(cortical TTP,PI,AUC)with Scr and BUN demonstrated the best diagnostic efficacy(AUC=0.953,sensitivity 87.3％,specificity 90.3％).Conclusion:CEUS can sensitively identify renal parenchymal injury associated with UTIs by dynamically assessing abnormal renal cortical blood perfusion.When combined with Scr and BUN,it significantly improves diagnostic accuracy,providing an important basis for early intervention and renal function protection in children with UTIs.

Transoral endoscopic thyroidectomy vestibular approach(TOETVA)has become a research hotspot because of its cosmetic advantages of no scar on the body surface,but there is still a risk of unique complications,among which mandibular sensory dysfunction is the most common,mainly related to mental nerve injury.This review focuses on the key anatomical structures closely related to the establishment of TOETVA space and the occurrence of complications.A deep understanding of the related anatomical structures of maxillofacial region and neck,especially the location and variation of mental nerve,the course of mandibular marginal branches of facial nerve,the level of mandibular muscles and the adjacent relationship of blood vessels,is the key to safely implement TOETVA and reduce postoperative complications.Preoperative image evaluation,intraoperative precise anatomy,following the design of safe area and improving the operation method in the future will contribute to the further promotion of this operation.

This consensus was developed by the Orthodontic Society of the Chinese Stomatological Association to provide a systematic, scientific, and practical guideline for informed consent in orthodontic care. Orthodontic treatment is typically lengthy, highly individualized, and involves multiple factors such as growth and development, occlusal function, and facial esthetics. Rapid technological advances and diverse risk profiles make the traditional reliance on orthodontist experience or institutional templates insufficient to ensure patients′ full understanding and autonomous decision-making. To address this, the expert panel conducted extensive reviews of domestic and international guidelines, analyzed representative dispute cases, and performed multicenter patient-clinician surveys. Using a multi-round Delphi method, the group established a standardized informed consent framework covering the initial consultation, treatment, and retention phases. The consensus emphasizes that informed consent is not only a fundamental legal and ethical requirement but also a key step in building trust, improving patient compliance, and enhancing treatment satisfaction. Orthodontists should clearly and comprehensively explain treatment plans, potential risks, uncertainties, and associated costs, while respecting the autonomy of patients or guardians, and maintain continuous communication and dynamic evaluation throughout the treatment process. The release of this consensus provides unified and authoritative guidance for clinical orthodontics, helping to standardize informed consent, enhance its transparency, safeguard patient rights, reduce medical risks, and promote high-quality, sustainable development of orthodontic practice.

Objective:To investigate the early diagnostic value of contrast-enhanced ultrasound(CEUS)combined with serum creatinine(Scr)and urea nitrogen(BUN)in children with renal parenchymal injury caused by urinary tract infections(UTIs).Methods:A total of 120 children with UTIs admitted from January 2020 to January 2025 were selected and divided into a renal parenchymal injury group(n=65)and a non-injury group(n=55)based on the results of 99mTc-DMSA renal static imaging.All children underwent CEUS examination within 24 hours of admission to obtain hemodynamic parameters of the renal cortex and medulla(time-to-peak[TTP],peak intensity[PI],and area under the curve[AUC]),and Scr and BUN levels were measured.Multivariate logistic regression analysis was used to identify independent risk factors,and the diagnostic efficacy was evaluated using receiver operating characteristic(ROC)curves.Results:In the renal parenchymal injury group,Scr(0.82±0.25 vs 0.53±0.15 mg/dL),BUN(16.23±4.82 vs 12.42±3.27 mg/dL),and cortical TTP(51.47±12.38 vs 43.45±12.55 s)were significantly elevated,while cortical PI(32.63±6.37 vs 39.23±7.31 dB)and AUC(2915.36±536.37 vs 3415.35±681.5 dB·s)were significantly decreased(all P＜0.05).Multivariate analysis showed that Scr(OR=6.17),BUN(OR=2.58),cortical TTP(OR=1.98),and PI(OR=0.60)were independent predictors.In the ROC curve analysis,the combination of CEUS parameters(cortical TTP,PI,AUC)with Scr and BUN demonstrated the best diagnostic efficacy(AUC=0.953,sensitivity 87.3％,specificity 90.3％).Conclusion:CEUS can sensitively identify renal parenchymal injury associated with UTIs by dynamically assessing abnormal renal cortical blood perfusion.When combined with Scr and BUN,it significantly improves diagnostic accuracy,providing an important basis for early intervention and renal function protection in children with UTIs.

Objective: Huntington’s disease (HD) is characterized by motor, cognitive, and neuropsychiatric symptoms. Oculomotor impairments and gait variability have been independently considered as potential markers in HD. However, an integrated analysis of eye movement and gait is lacking. We performed multiple examinations of eye movement and gait variability in HTT mutation carriers, analyzed the consistency between these parameters and clinical severity, and then examined the associations between oculomotor impairments and gait deficits. Methods: We included 7 patients with pre-HD, 30 patients with HD and 30 age-matched controls. We collected demographic data and assessed the Unified Huntington’s Disease Rating Scale (UHDRS) score. Examinations, including saccades, smooth pursuit tests, and optokinetic (OPK) tests, were performed to evaluate eye movement function. The parameters of gait include stride length, walking velocity, step deviation, step length, and gait phase. Results: HD patients have significant impairments in the latency and velocity of saccades, the gain of smooth pursuit, and the gain and slow phase velocities of OPK tests. Only the speed of saccades significantly differed between pre-HD patients and controls. There are significant impairments in stride length, walking velocity, step length, and gait phase in HD patients. The parameters of eye movement and gait variability in HD patients were consistent with the UHDRS scores. There were significant correlations between eye movement and gait parameters. Conclusion Our results show that eye movement and gait are impaired in HD patients and that the speed of saccades is impaired early in pre-HD. Eye movement and gait abnormalities in HD patients are significantly correlated with clinical disease severity.

[Purpose]To analyze the epidemiology and disease burden of gastric cancer in China,Japan and Republic of Korea from 1990 to 2021 and to predict changing trends from 2022 to 2031.[Methods]Data were obtained from the Global Burden of Disease(GBD)database.Age-stan-dardized incidence rate(ASIR),age-standardized mortality rate(ASMR),crude incidence rate(CIR),crude mortality rate(CMR),and disability-adjusted life years(DALY)rate for China,Japan and Republic of Korea from 1990 to 2021 were analyzed.Joinpoint regression software was used to analyze trends and calculate annual percentage changes.The autoregressive integrated moving average(ARIMA)model was applied to predict incidence and mortality from 2022 to 2031.[Results]In 2021,China had 611 799 new gastric cancer cases and 445 013 deaths,with an ASIR of 29.05/105 and an ASMR of 21.51/105,both significantly higher than those in Japan and Republic of Korea.Among men in China,both the ASIR(44.48/105)and ASMR(32.61/105)were the highest among the three countries,exceeding those in Japan(38.77/105,20.26/105)and Re-public of Korea(38.98/105,20.50/105).Among women,China had the highest number of new cases,but its ASIR(15.23/105)was slightly lower than Republic of Korea's(15.57/105)and higher than Japan's(14.66/105).However,China's ASMR among women(12.02/105)remained significantly higher than Japan's(7.64/105)and Republic of Korea's(8.08/105).From 1990 to 2021,ASIR,ASMR and DALY rates for gastric cancer declined in all three countries,but the reduction in China was significantly smaller than that in Japan and Republic of Korea,with Republic of Korea showing the steepest declines across all indicators.ARIMA model predictions indicated significant differences in disease burden among the three countries from 2022 to 2031.ASIR is projected to continue declining in China and Republic of Korea,reaching 22.87/105 and 12.45/105,respectively by 2031,while in Japan it is predicted to rise to 26.55/105.ASMR is projected to decline in all three countries,reaching 13.71/105(China),10.44/105(Japan),and 9.08/105(Republic of Korea)in 2031.[Conclusion]Among China,Japan and Republic of Korea,China had the highest ASIR and ASMR of gastric cancer in 2021.Moreover,from 1990 to 2021,the reductions in ASIR,ASMR and DALY rates for gastric cancer were the smallest in China compared to Japan and Republic of Korea.These findings suggest that the disease burden of gastric cancer remains substantial in China,high-lighting the need for increased efforts in gastric cancer screening and early diagnosis and treatment.

Objective:To investigate the impact of immunosuppressive therapy on the severity of SARS-CoV-2 infection and cytokine levels in pediatric patients with kidney diseases.Methods:A retrospective analysis was conducted on the clinical data of 40 hospitalized pediatric patients who were diagnosed with SARS-CoV-2 infection at the 900th Hospital of PLA Joint Logistic Support Force from December 2022 to February 2023. Based on their immunosuppressive status prior to SARS-CoV-2 infection, these patients were categorized into immunosuppressive group and non-immunosuppressive group. Independent sample t-tests, Mann-Whitney U tests, and χ2 test were employed to compare the clinical baseline characteristics and laboratory data, the severity of SARS-CoV-2 infection, and the levels of cytokines between the 2 groups. Results:Among the 40 patients, 11 were in the immunosuppressive group (aged 13 (8, 14) years, 9 males and 2 females) and 29 in the non-immunosuppressive group (aged 2 (1, 4) years, 15 males and 14 females). In the immunosuppressive group, 2 were asymptomatic cases, 8 were mild cases, and 1 was moderate case, and there was no severe or critical cases. In the non-immunosuppressive group, 8 were mild cases, 5 were moderate, 15 were severe cases, 1 was critical case, and no asymptomatic cases. The underlying diseases in the immunosuppressive group included nephrotic syndrome (6 cases), IgA vasculitis nephritis (2 cases), lupus nephritis (1 case), post-renal transplantation (1 case), and renal failure (1 case), with a mean total immunosuppression score (TIS) of (3.6±1.4) points. In the non-immunosuppressive group, 2 patients had a history of epilepsy, and the remaining 27 cases had no underlying conditions, all with TIS scores of 0. Compared to the children in the non-immunosuppressive group, those in the immunosuppressive group were more likely to exhibit asymptomatic or mild infection, with lower risks of severe disease, cytokine storm, fever, and cough, but a higher risk of fatigue ( OR=1.22, 2.66, 0.48, 0.12, 0.12, 0.13, 1.22; 95% CI 0.93-1.62, 0.99-7.15, 0.33-0.70, 0.03-0.57, 0.03-0.57, 0.03-0.65, 0.93-1.62; all P<0.05). The levels of cytokine IL-6, interferon-α and interferon-γ in the immunosuppressive group were all lower than those in the non-immunosuppressive group ( Z=2.23, 2.51, 2.92, respectively; all P<0.05). Conclusion:Pediatric patients with kidney diseases receiving appropriate immunosuppressive therapy may mitigate the severity of SARS-CoV-2 infection by suppressing the expression of cytokines.